COVID-19 BASIC INFO

PRESENTATION (1):

  • Fever
  • Dry cough
  • Shortness of breath
  • Fatigue
  • Myalgia (muscle pain)
  • Rare: upper respiratory tract symptoms (nasal congestion, nasal discharge and sore throat) and gastrointestinal symptoms (abdominal pain and diarrhea)

COMMON LAB FINDINGS:

  • Normal WBC count
  • Elevated: LDH, AST, ALT, hs-CRP
  • Reduced: platelets, lymphocytes, albumin
  • CT positive for bilateral patches (>3cm) of ground glass opacities in the periphery of multiple lobes of the lungs

CONCERNING OUTCOMES:

  • Severe pneumonia
  • Pulmonary edema
  • Cytokine storm
  • Acute respiratory distress syndrome (ARDS)
  • Multiple organ failure
  • Micro-clotting

CONCERNING LAB FINDINGS (MAY SUGGEST CYTOKINE STORM AND PROGRESSION TO ACUTE RESPIRATORY DISTRESS SYNDROME OR MUTLI ORGAN FAILURE DUE TO CLOTTING):

  • High ferritin
  • High ESR
  • High D-dimer

RISK FACTORS FOR DEVELOPING SEVERE DISEASE (2):

  • Male > Female
  • Co-morbidities: hypertension, diabetes, cardiovascular disease, COPD, malignancy (3)
  • No or low fever
  • Smoking
  • Age > 50

HOSPITAL INTERVENTIONS:

  • Suplemental oxygen
  • Mechanical ventilation
  • Corticosteroids
  • Immunoglobulin
  • Expectorants
  • Trials of the following ongoing:
    • Antivirals: lopinavir and ritonavir, Interferon
    • Antimalarials: Hydroxychloroquine (Plaquinil) or Chloroquine (considered in combination with azithromycin)

References:

1. AJR Am J Roentgenol. 2020 Mar 17:1-6. doi: 10.2214/AJR.20.22961. [Epub ahead of print]. Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia. Han R et al.

https://www.ncbi.nlm.nih.gov/pubmed/32181672#

2. Clin Infect Dis. 2020 Mar 16. pii: ciaa270. doi: 10.1093/cid/ciaa270. [Epub ahead of print]. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Mo P et al.

https://www.ncbi.nlm.nih.gov/pubmed/32173725

3. Eur Respir J. 2020 Mar 26. pii: 2000547. doi: 10.1183/13993003.00547-2020. [Epub ahead of print]

Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis. Guan WJ et al.

https://www.ncbi.nlm.nih.gov/pubmed/32217650

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